Case Manager RN

Globalhealth Holdings - Oklahoma City, OK

Full-time - Mid Level

Oklahoma City, OK

Ambulatory Health Care Services

About the position

The Case Manager RN at GlobalHealth Holdings LLC is responsible for managing all aspects of care management for complex, high-risk members. This role involves advocating for members through coordination of care, conducting telephonic case management, and ensuring holistic health outcomes. The position requires strong organizational skills and the ability to communicate effectively with members and healthcare providers.

Responsibilities

• Conduct telephonic case management for complex, high-risk members, including needs assessment and care coordination.
• Coordinate with providers to ensure beneficial health outcomes for members.
• Communicate with respect to family culture, ethnic origin, race, language, gender, age, religion, socioeconomic status, sexual orientation, and mental/physical challenges.
• Provide patient advocacy, support, and crisis intervention through interdepartmental and network communication.
• Coordinate services for members, including community resources and collaboration with the care team.
• Educate members and caregivers on conditions and self-management techniques.
• Initiate and participate in all elements of the SNP MOC, including completing HRA, creating ICP, and initiating ICT.
• Complete TOC activities, including post-discharge assessment and medication reconciliation.

Requirements

• Active Registered Nurse license in the state of Oklahoma required.
• Active multi-state RN license is preferred.
• Previous experience in managed care/utilization management preferred.
• Knowledge of current nursing processes, techniques, and established standards.
• Strong attention to detail and good organizational and time management skills.
• Ability to communicate clearly and effectively, both orally and in writing.
• Proficiency in Microsoft Word, Excel, and PowerPoint.

Nice-to-haves

• Experience in disease management and community resources.
• Ability to work independently or as part of a team.

Benefits

• Health insurance